[Two cases of human epidermal growth factor receptor 2-positive advanced gastric cancer successfully treated with S-1, cisplatin, and trastuzumab combination therapy followed by curative resection]

Gan To Kagaku Ryoho. 2013 Nov;40(12):2203-6.
[Article in Japanese]

Abstract

We report 2 cases of human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer successfully treated with a combination therapy of S-1, cisplatin( CDDP), and trastuzumab followed by curative resection. Case 1 involved a 62-year-old man with type 3 HER2-positive gastric cancer spanning the antrum of the stomach to the duodenal bulb and directly invading the pancreatic head( cT4b[ Panc] N3H0P0M0, Stage IIIC). We diagnosed it as an unresectable cancer, and selected S-1, CDDP, and trastuzumab for combination chemotherapy. S-1 (120 mg/body/day) was administered orally for 2 weeks, followed by 1 drug-free week as a course, and CDDP (60 mg/m2) and trastuzumab (8 mg/kg loading dose and 6 mg/kg maintenance) were administered by intravenous infusion on day 1. After the third course, significant tumor and lymph node reduction was observed; however, pyloric stenosis developed. Distal gastrectomy with D2 lymphadenectomy was performed. Case 2 involved a 62-year-old woman with type 4 HER2-positive gastric cancer from the angle of the stomach to the duodenal bulb and directly invading the pancreatic head (cT4b [Panc] N2H0P0M0, Stage IIIC). After the third course of combination therapy, significant tumor reduction and disappearance of lymph nodes metastasis was observed. We diagnosed the patient as having a resectable cancer, and performed distal gastrectomy with D2 lymphadenectomy.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / surgery
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Drug Combinations
  • Female
  • Gastrectomy
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Oxonic Acid / administration & dosage
  • Receptor, ErbB-2 / analysis
  • Stomach Neoplasms / chemistry
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery
  • Tegafur / administration & dosage
  • Trastuzumab

Substances

  • Antibodies, Monoclonal, Humanized
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Cisplatin